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BACKGROUND: Health risk appraisals (HRAs) in occupational health services (OHS) in Sweden are very commonly used for health promotion issues, but not much research has explored the extent and nature of individual feedback that is provided. OBJECTIVES: This study aimed to describe and explore HRAs in OHS regarding the content of the feedback in relation to the individual status and overall employee satisfaction. METHODS: Feedback (evaluation and advice) and employee satisfaction with HRA were studied in employees that participated in health risk appraisals with a specific feedback session (HRA-F) (n = 272) and employees that participated in a single session (HRA-S) (n = 104). Associations between feedback and individual status concerning life style were assessed with Cohen's kappa (k). RESULTS: The employees received mainly information and advice for improvement on health and lifestyle issues (89-100%), while advice for improvement of working conditions was less common (15-59%). The feedback provided on life style was not based on individual status (k < 0.4), except for smoking and risky alcohol consumption (k > 0.55). A great majority of employees reported good overall satisfaction with their HRAs. CONCLUSIONS: The evaluation and feedback given to employees after HRAs should be based more on HRA-results and advice could be focused more on work-related factors.

Background: Occupational health services may have a strategic role in the prevention of sickness absence, as well as in rehabilitation and return to work after sick leave, because of their medical expertise in combination with a close connection to workplaces. The purpose of this study was to explore how employers and occupational health service providers describe their business relations and the use of occupational health services in rehabilitation in relation to the organization of such services. The study uses a theoretical framework based on social capital to analyse the findings. Methods: Interviews and focus groups with managers with Swedish public employers (n = 60), and interviews with occupational health services professionals (n = 25). Results: Employers emphasized trustful relationships, local workplace knowledge, long-term contracts and dialogue about services for good relationships with occupational health providers. Occupational health providers strove to be strategic partners to employers, promoting preventive work, which was more easily achieved in situations where the services were organized in-house. Employers with outsourced occupational health services expressed less trust in their providers than employers with internal occupational health provision. Conclusions: Social capital emerges as central to understanding the conditions for cooperation and collective action in the use of occupational health services, with reference to structural (e.g. contracts), relational (e.g. trust) as well as cognitive (e.g. shared vision) dimensions. The study suggests that attention to the quality of relationships is imperative for developing purposeful occupational health service delivery in rehabilitation and return to work.

QC 20230731

BACKGROUND: Symptoms from the eyes are common among computer users. Knowledge is scarce about these problems, however. OBJECTIVES: The aim was to study risk-factors, incidence and persistence of eye-symptoms among professionally active computer users. METHODS: This was a questionnaire based prospective study where 1283 males and females from different professions and companies answered a baseline questionnaire about individual factors and working conditions, e.g. duration of daily computer work, comfort of screen work, psychosocial factors. Subjects were at baseline and 10 follow-ups asked about the number of days with eye-symptoms during the preceding month. RESULTS: The incidence-rate of symptoms persisting minimum three days was 0.38/person-year. A multivariate Hazard-ratio model showed significant associations with extended continuous computer work, tasks with high demands on eye-hand coordination, low level of control, visual discomfort, female sex and nicotine use. Eye-symptoms at baseline was a strong risk factor for new symptoms. CONCLUSION: The incidence of eye-symptoms among professional computer users is high and related to both individual and work-related factors. The organization of computer work should secure frequent breaks from near-work at the computer screen. The severity of vision-related problems could in field studies be quantified by asking for the persistence of symptoms.

Background: In 2010, the Swedish government introduced a system of subsidies for occupational health (OH) service interventions, as a part in a general policy promoting early return to work. The aim of this study was to analyse the implementation of these subsidies, regarding how they were used and perceived. Methods: The study was carried out using a mixed-methods approach, and comprises material from six sub-studies: a register study of the use of the subsidies, one survey to OH service providers, one survey to employers, one document analysis of the documentation from interventions, interviews with stakeholders, and case interviews with actors involved in coordinated interventions. Results: The subsidized services were generally perceived as positive but were modestly used. The most extensive subsidy - for coordinated interventions - was rarely used. Employers and OH service providers reported few or no effects on services and contracts. OH service providers explained the modest use in terms of already having less bureaucratic routines in place, where applying for subsidies would involve additional costs. Information about the subsidies was primarily communicated to OH service providers, while employers were not informed. Conclusions: The study highlights the complexity of promoting interventions through financial incentives, since their implementation requires that they are perceived by the stakeholders involved as purposeful, manageable and cost-effective. There are inherent political challenges in influencing stakeholders who act on a free market, in that the impact of policies may be limited, unless they are enforced by law.

BACKGROUND: The aim of this study was to investigate whether perceived exertion, perceived comfort and working technique is associated with the incidence of neck and upper extremity symptoms among professional computer users. METHODS: At baseline a self-administered questionnaire was distributed to 853 participants from 46 different work sites (382 men and 471 women) who, at baseline, had been free from neck and upper extremity symptoms during the preceding month. Work-related exposures, individual factors, and symptoms from the neck and upper extremities were assessed. Observations of working technique were performed by ergonomists using an ergonomic checklist. Incidence data were collected by means of 10 monthly questionnaires, asking for information on the occurrence of neck, shoulder and arm/hand symptoms. Perceived exertion was rated on a modified Borg RPE scale ranging from 0 (very, very light) to 14 (very, very strenuous). Perceived comfort was rated on a 9-point scale ranging from -4 (very, very poor) to +4 (very, very good) in relation to the chair, computer screen, keyboard, and computer mouse. RESULTS: The median follow up time was 10.3 months. The incidence of symptoms from the neck, shoulders and arm/hands were 50, 24 and 34 cases per 100 person years, respectively.Higher perceived exertion in the neck, shoulder or arm/hands was associated with an increased risk of developing symptoms in the corresponding body region. Moreover, a dose-response relationship between the level of exertion and the risk of developing symptoms was recorded for all three regions. There was an association between low comfort and an increased risk for neck symptoms, but not for shoulder and arm/hand symptoms, although a trend towards such an association (not statistically significant) could be seen. Working technique was, in this study, not associated with the risk of developing symptoms in any of the investigated body regions. CONCLUSION: There was a strong association between

Background: The dose and time-pattern of sitting has been suggested in public health research to be an important determinant of risk for developing a number of diseases, including cardiovascular disorders and diabetes. The aim of the present study was to assess the time-pattern of seated and standing/walking postures amongst male and female call centre operators, on the basis of whole-shift posture recordings, analysed and described by a number of novel variables describing posture variation. Methods: Seated vs. standing/walking was recorded using dichotomous inclinometers throughout an entire work shift for 43 male and 97 female call centre operators at 16 call centres. Data were analysed using an extensive set of variables describing occurrence of and switches between seated and standing/walking, posture similarity across the day, and compliance with standard recommendations for computer work. Results: The majority of the operators, both male and female, spent more than 80% of the shift in a seated posture with an average of 10.4 switches/hour between seated and standing/walking or vice versa. Females spent, on average, 11% of the day in periods of sustained sitting longer than 1 hour; males 4.6% (p = 0.013). Only 38% and 11% of the operators complied with standard recommendations of getting an uninterrupted break from seated posture of at least 5 or 10 minutes, respectively, within each hour of work. Two thirds of all investigated variables showed coefficients of variation between subjects above 0.5. Since work tasks and contractual break schedules were observed to be essentially similar across operators and across days, this indicates that sedentary behaviours differed substantially between individuals. Conclusions: The extensive occurrence of uninterrupted seated work indicates that efforts should be made at call centres - and probably in other settings in the office sector - to introduce more physical variation in terms of standing/walking periods during the w

In a clear and accessible presentation, Occupational Physiology focuses on important issues in the modern working life. Exploring major public health problems such as musculoskeletal disorders and stress, this book explains connections between work, well-being, and health based on up-to-date research in the field. It provides useful methods for risk assessments and guidelines on arranging a good working life from the perspective of the working individual, the company, and society as a whole. The book focuses on common, stressful situations in different professions in work life. Reviewing bodily demands and reactions in eight selected common but contrasting job types, the book explains relevant physiology in a novel way. Rather than being structured according to organs in the body, the book accepts the complex physiology of typical jobs and uses this as an entry. In addition to physiological facts, the book discusses risk factors for disorders and gives ideas on how to organize and design work and tasks so as to optimize health, work ability, and productivity. Although many books cover physiology, they are based on a traditional anatomical structure (e.g., addressing the physiology of the cardiovascular system, the gastrointestinal system, and so forth) and require readers to synthesize this knowledge into real-life complex applications. Occupational Physiology is, instead, structured around a number of typical jobs and explains their physiology, as complex as they may be. This approach, while still presenting the physiology needed to understand occupational life, demonstrates how to use this information in situations encountered in practice.

Personal computers are used by a majority of the working population in their professions. Little is known about risk-factors for incident symptoms from the eyes among professional computer users. The aim was to study the incidence and risk-factors for symptoms from the eyes among professional computer users. This study is a part of a comprehensive prospective follow-up study of factors associated with the incidence of symptoms among professional computer users. 1531 computer users of different professions at 46 companies were invited, whereof 1283 answered a baseline questionnaire (498 men; 785 women) and 1246 at least one of 10 monthly follow-up questionnaires. The computer work-station and equipment were generally of a good standard. The majority used CRT displays. During the follow-up period 329 subjects reported eye symptoms. The overall incidence rate in the whole study group was 0.38 per person-year, 0.23 in the subgroup of subjects who were symptom free at baseline and 1.06 among subjects who reported eye symptoms at baseline. In the bivariate analyses significant associations were found with all explanatory variables, except BMI. The reduced multivariate model showed significant associations with extended computer work, visual discomfort (dose-response), eye symptoms at baseline (higher risk), sex (women=higher risk) and nicotine use. The incidence of eye problems among professional computer users is high and related to both individual and work-related factors., Incidence and risk factors for symptoms from the eyes among professional computer users

Introduction: Adults spend approximately 8 to 9 hours of the day in sedentary behavior and much of this is gathered at work. The rising level of occupational sedentary behavior is both a public health and occupational health concern due to the emerging evidence regarding the deleterious effect that sedentary behavior has on health, independent of physical activity. In the occupational setting, sit-stand desks have been purported to offer a means of reducing sedentariness. This study aimed to investigate whether or not use of sit-stand desks and awareness of the importance of postural variation and breaks are associated with the pattern of sedentary behavior in call centre workers. Method: The data came from a cross-sectional observation study of fifteen Swedish call centres, carried out in 2002–2003. Ten operators were randomly selected from each of the call centres and invited to participate. Inclinometers recorded ‘seated’ or ‘standing/walking’ episodes of the operators over a full work shift. Differences in sedentary behavior based on desk type (categorized as ‘sit-stand’ or ‘sit’) and awareness of the importance of posture variation and breaking up seated computer work within those using a sit-stand desk were assessed by non-parametric analyses. Results: Four operators declined to participate and 15 operators had inclinometer recordings that were not of sufficient quality. Of the remaining 131 operators, 90 (68.7%) worked at a sit-stand desk. Working at a sit-stand desk, as opposed to a sit desk, was associated with a modest reduction in the time seated (78.5 vs 83.8%, p = 0.010), and less time taken to accumulate 5 minutes of standing/walking (36.2 vs 46.3 minutes, p = 0.022), but no significant difference to sitting episode length or the number of switches between sitting and standing/walking per hour. Ergonomics awareness had no significant association with any sedentary behavior pattern variable among those using a sit-stand desk. Conclusion: Use of sit-stan

Objective: To identify risk indicators for high stress and low mental energy as well as to describe psychosocial working conditions at different types of call centres. Participants: 1183 operators from 28 call centres in Sweden, both external and internal, with different levels of task complexity, ownership and geographical location. Method: A cross sectional questionnaire study. Results: The stress level was moderately high and the energy level fairly high. Stress levels tended to be lower and psychosocial conditions better with increasing level of task complexity. Fourteen per cent of the operators were in a state of high stress/low energy ("worn out") and 47% in high stress/high energy ("committed under pressure"). Operators in a state of low stress/high energy ("committed without pressure") were most likely to report a better health status. High stress and lack of energy was mainly associated with time pressure, low decision latitude, and lack of social and supervisor support. Conclusions: Time pressure in combination with lack of support and influence should be seen as a potential high risk situation for the development of a "worn-out" state among call centre operators. Management should make use of this knowledge in order to promote a long lasting efficient and healthy call centre work., QC 20110208

QC 20210616

QC 20210616

QC 20210621

Objectives: Call centres (CCs) are one of the most rapidly growing types of workplaces in Sweden. The purpose of the study was to assess associations between exposures at CC work and symptoms in the Neck/shoulders and Arm/hand. Comparisons were made between internal and external CCs. An internal CC is a department or separate unit within a larger company with another main core business, while an external CC is a free-standing company. Methods: A cross-sectional study of a selected sample of CCs was conducted. A questionnaire, covering characteristics of work and management, physical and psychosocial exposures and symptoms during the last month, was answered by 1183 operators from 28 CCs. Results: Three out of four operators reported pain or aches in one or more of the requested body regions, with no major difference between internal and external CC operators. Comfort of the work environment, showed the strongest association with symptoms in the Neck/shoulder and Arm/hand, in both types of CCs. Other exposures associated with symptoms in the Neck/shoulder or Arm/hand in either type of CC were: low complexity of work, long total time of customer calls per day, continuous computer work without a break, high psychological demands, low decision latitude, lack of social support from colleagues and supervisor. Conclusions: The study is unique in that there are no previous studies focusing on a large variety of exposures specific to CC work, based on a large number of workers from different types of CCs. The study confirms previously suggested associations between unfavourable work characteristics and management, a poor physical and psychosocial environment, and musculoskeletal symptoms in computer-telephone interactive tasks. The nature of calls during work were related to symptoms of persons working in internal CCs, whereas the time spent seated and continuous computer work were related to symptoms of those in external CCs., QC 20100525

QC 20120113

Background. Call centres (CCs) are among the most rapidly growing forms of workplaces in Sweden. The purpose of the study was to describe and compare working conditions between operators at internal and external CC companies and work tasks of different complexity. Method. A questionnaire was answered by 1183 operators, 848 women and 335 men, from 28 different CCs. The questionnaire covered background factors, employment, working hours and remuneration, call logging and monitoring, duties, computer work and workplace design during the previous month. Results. Operators at external companies and operators with low-complexity work tasks were younger, more often employed by the hour and worked on a varying roster. They spent longer time on customer calls and had less varied tasks. Additional remuneration, call logging and monitoring were more common at external companies and among operators with low-complexity work tasks. Conclusion. The working conditions varied between internal and external CCs. There was also a variation in working conditions between work tasks of different complexity. There were aspects of supervision style and organization of work at CCs, especially at external ones and those with low-complexity tasks that could introduce stress and lack of well being among the staff., QC 20100525

Background. Call centres (CCs) are among the most rapidly growing forms of workplaces in Sweden. The purpose of the study was to describe and compare working conditions between operators at internal and external CC companies and work tasks of different complexity. Method. A questionnaire was answered by 1 183 operators, 848 women and 335 men, from 28 different CCs. The questionnaire covered background factors, employment, working hours and remuneration, call logging and monitoring, duties, computer work and workplace design during the previous month. Results. Operators at external companies and operators with low-complexity work tasks were younger, more often employed by the hour and worked on a varying roster. They spent longer time on customer calls and had less varied tasks. Additional remuneration, call logging and monitoring were more common at external companies and among operators with low-complexity work tasks. Conclusion. The working conditions varied between internal and external CCs. There was also a variation in working conditions between work tasks of different complexity. There were aspects of supervision style and organization of work at CCs, especially at external ones and those with low-complexity tasks that could introduce stress and lack of well being among the staff.

Objectives: Call centres (CCs) are one of the most rapidly growing types of workplaces in Sweden. The purpose of the study was to assess associations between exposures at CC work and symptoms in the Neck/shoulders and Arm/hand. Comparisons were made between internal and external CCs. An internal CC is a department or separate unit within a larger company with another main core business, while an external CC is a free-standing company. Methods: A cross-sectional study of a selected sample of CCs was conducted. A questionnaire, covering characteristics of work and management, physical and psychosocial exposures and symptoms during the last month, was answered by 1183 operators from 28 CCs. Results: Three out of four operators reported pain or aches in one or more of the requested body regions, with no major difference between internal and external CC operators. Comfort of the work environment, showed the strongest association with symptoms in the Neck/shoulder and Arm/hand, in both types of CCs. Other exposures associated with symptoms in the Neck/shoulder or Arm/hand in either type of CC were: low complexity of work, long total time of customer calls per day, continuous computer work without a break, high psychological demands, low decision latitude, lack of social support from colleagues and supervisor. Conclusions: The study is unique in that there are no previous studies focusing on a large variety of exposures specific to CC work, based on a large number of workers from different types of CCs. The study confirms previously suggested associations between unfavourable work characteristics and management, a poor physical and psychosocial environment, and musculoskeletal symptoms in computer-telephone interactive tasks. The nature of calls during work were related to symptoms of persons working in internal CCs, whereas the time spent seated and continuous computer work were related to symptoms of those in external CCs.

Objectives Computer use, neck and upper-extremity symptoms, headache, and eyestrain were studied in upper secondary school students.Methods A questionnaire was completed by 1575 female and 1251 male students. Associations between computer use and health problems were analyzed by calculating the prevalence ratios for the health variables, considering computer use for ＞14-56 or ＞56 hours/week as compared with ≤14 hours/week (reference). Health problems were defined as aches or pain or other trouble at least three days in the preceding month.Results Computer use (median) was reported to be 31 hours/week by the male students and 19 hours/week by the females. Most computer use (about 90%) took place outside school (eg, for entertainment). Headache was reported by 51% and 24%, and neck or shoulder symptoms by 31% and 15%, of the females and males, respectively. More than 50% of the females with health complaints indicated that their problems had disturbed their sleep, and they used painkillers to handle them. Between 10% and 43% experienced their health complaints as being related to computer use. For those using computers ＞56 hours/week, the prevalence ratios were significantly increased for neck or shoulder symptoms among both the females and the males, and for eyestrain and forearm symptoms among the females. Exposure-response relationships were indicated for the aforementioned associations. Approximately two-thirds of the students reported that they had not received any information in school about appropriate workplace layout and techniques for computer work.Conclusions Despite their young age, the students were not protected from computer-related health complaints. Therefore, providing adolescents with information about proper computer ergonomics may help prevent such health problems.